Congressional Hearing Focuses On Surprise Bills

By Consumers For Quality Care, on April 9, 2019

A recent hearing on surprise bills in the House Education & Labor Committee’s Health, Employment, Labor, and Pensions Subcommittee featured a resounding message: consumers should be protected from unexpected medical bills. The hearing comes at a time when surprise billing has been increasingly in the public spotlight. NPR, which reported on the hearing, has partnered with Kaiser Health News to increase awareness on the issue.

"It is the providers and insurers, not patients, who should bear the burden of settling on a fair payment," said Frederick Isasi, the executive director of Families USA. He was one of the witnesses who testified before the House Health, Employment, Labor and Pensions Subcommittee of the Education & Labor Committee.

Testimony from advocates and experts at the hearing emphasized that billing and payment concerns should be deliberated between providers and insurers, leaving consumers out of the middle. While the witnesses said that transparency is important, they said that it alone would not solve the surprise billing issue for consumers. They testified that potential federal policy fixes should focus on preventing surprise bills, rather than creating mechanisms to help consumers negotiate once they receive them. Witnesses discussed potential policy solutions like incentivizing doctors to stay in-network or putting caps on what out-of-network doctors can charge.

Right now, if doctors opt out of an insurance network, they can charge prices that are "largely made up," said Christen Linke Young, a fellow at USC-Brookings Schaeffer Initiative for Health Policy.

"We need to limit how much they can be paid in out-of-network scenarios to make it less attractive," Young said.

Rep. Tim Walberg (R-MI), the subcommittee’s ranking member, expressed optimism about the subcommittee’s efforts to better understand how to help consumers. Rep. Susan Wild (D-PA) was hopeful that surprise billing is an issue that can be solved with bipartisan support.

"We have people on this committee that have done yeoman efforts to come up with solutions in their own states," said Rep. Tim Walberg… "I think we have a head start in understanding some of the pitfalls to stay away from and some of the benefits we can go directly toward."

Consumers for Quality Care has previously highlighted lawmakers’ efforts to resolve the issue for consumers, including bipartisan support for a bill in the Senate.